Nonspecific craniovertebral spondylitis

Lisitsky IYu, Lychagin AV, Zarov AYu, Korkunov AL, Cherepanov VG, Vyzankin IA, Tselishcheva EYu. Nonspecific craniovertebral spondylitis. Burdenko's Journal of Neurosurgery. 2024;88(3):21‑30. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20248803121

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

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Abstract:

OBJECTIVE

To analyze surgical strategy for nonspecific spondylitis of the craniovertebral region (CVR) taking into account clinical features and morphological signs of disease.

MATERIAL AND METHODS

Eight patients with nonspecific spondylitis of CVR underwent surgery (4 women and 4 men aged 31—75 years). Three patients had pain syndrome, 5 ones — conduction disorders. Combined interventions were performed in 5 patients with neurological disorders. Of these, 3 patients underwent transoral decompression with subsequent occipitospondylodesis. In other cases, stages of surgical treatment were reverse. Four patients underwent simultaneous interventions, 1 patient — with 7-day interval. Patients with pain syndrome underwent occipitospondylodesis.

RESULTS

In all patients, postoperative VAS score of pain syndrome decreased by 5—7 points (mean 5.5). Among 5 patients with conduction symptoms, regression of neurological disorders 1 year after surgery was achieved in 2 cases, and complete recovery was observed in 3 patients (Frankel E). In all cases, examination confirmed relief of inflammatory process and no compression of the spinal cord and medulla oblongata. One patient had a dehiscence of the wound edges of posterior pharyngeal wall, and another one had implant fracture in 3 years after surgery.

CONCLUSION

Active surgical approach is reasonable for nonspecific spondylitis of CVR. Craniocervical fixation eliminates pain and risk of neurological complications following atlantoaxial instability. Conduction disorders require simultaneous transoral decompression and occipitospondylodesis in patients with nonspecific purulent craniovertebral lesions. Impaired head tilt complicates transoral stage. In this regard, it is more rational to carry out craniocervical fixation at the last stage.

Keywords:

nonspecific spondylitis of CVR

transoral decompression

occipitospondylodesis

Authors:

Lisitsky I.Yu.

Sechenov First Moscow State Medical University

ORCID: 0000-0003-2475-6278

Lychagin A.V.

Sechenov First Moscow State Medical University

ORCID: 0000-0002-2202-8149

Zarov A.Yu.

Sechenov First Moscow State Medical University

ORCID: 0000-0001-6381-5651

Korkunov A.L.

Sechenov First Moscow State Medical University

ORCID: 0000-0001-6331-0290

Cherepanov V.G.

Sechenov First Moscow State Medical University

ORCID: 0000-0003-0797-6383

Vyzankin I.A.

Sechenov First Moscow State Medical University

ORCID: 0000-0002-8020-2950

Tselishcheva E.Yu.

Sechenov First Moscow State Medical University

ORCID: 0000-0002-1669-3935

Received:

23.11.2023

Accepted:

22.03.2024

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